Sofie Wise

Shannon Chapman

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About Author — Shannon enjoys breaking down technical subjects and giving others the tools to make informed decisions. Her interests include behavioral economics, sustainable living, meditation, and healthy cooking.

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog.

Non Hormonal & Low Hormone Birth Control Explained

With the continuing advancement of birth control methods, there are a variety of choices for women depending on their needs. There are forms of birth control without hormones, birth control with one type of hormone, or with multiple. Each form has its own pros and cons. And it’s no surprise that women often wonder which birth control would work best for their bodies when they are starting out or switching methods.

Between side effects, PMS and period symptom control or, most importantly, preventing pregnancy, it’s important to know how much and when you can count on your birth control to work properly and keep your body healthy.

Below are some of the most common types of birth control methods and whether they are non-hormonal, low-hormone, or include a combination of hormones. Knowing this is crucial for planning for a safe and healthy sexual life.

Want to speak with an online doctor about your birth control? Click here.

Types of Birth Control

There are many different types of birth control, from pills to implants to physical barriers. Let’s look at some of the most common forms and whether they are hormone free birth control, low dose birth control, or high hormone birth control.

Non Hormonal Birth Control Options: Condoms, Diaphragms, Cervical Caps, and Spermicide

Condoms, diaphragms, and cervical caps are all forms of physical birth controls or barrier birth controls. Instead of using hormones to change your body chemistry into not producing the necessary environment to get pregnant, they simply block the sperm from entering the cervix.

  • Condoms A thin layer of latex or similar rubbery material that creates a physical barrier between male and female genitals during sex, condoms are available for both males and females.

Condoms are easy to use, readily available, cheap, and you won’t need a prescription to get one! In addition to preventing pregnancy, both male and female condoms protect against sexually-transmitted diseases (STDs).

When used perfectly, male condoms are about 98 percent effective and female condoms are about 95 percent effective at preventing pregnancy. However, with typical use (i.e. how most people use them), their effectiveness drops to about 85 and 79 percent effective, respectively, according to Planned Parenthood. Given these numbers, it may be a good idea to pair condoms with another form of birth control.

  • Cervical Caps are also a form of physical barrier birth control that helps prevent pregnancy. This sailor hat-shaped silicon device goes in front of a woman’s cervix to prevent sperm from fertilizing an egg. A cervical cap is used every time for sexual intercourse and varies in effectiveness, depending on how well it is used. Cervical caps work best for women who have never given birth. Cervical caps need to be combined with spermicide, a chemical compound that kills sperm before they can fertilize an egg. This double approach helps increase the effectiveness of cervical caps.
  • Diaphragms are similar to the cervical caps explained above, but come in a different shape. A diaphragm is a dome-shaped insert that is used to cover your cervix during intercourse. Like cervical caps, diaphragms have no hormones because they are a barrier type of birth control. For maximum effectiveness, diaphragms should also be used with spermicide to both block off your cervix and also kill sperm before they enter. Diaphragms boast a relatively high effectiveness percentage when used correctly (up to 92%).
  • Spermicide is a chemical that is placed inside the vagina before sex. Spermicides kill the sperm before they can reach and fertilize the egg. Unfortunately, spermicides also have a failure rate of about 28 percent according to the American Pregnancy Association. Because of this, spermicides should not be used as a sole method of birth control, but are a great addition to another non-hormonal birth control method such as a cervical cap or diaphragm.

Because condoms contain no hormones, they have no side effects. Unless the latex causes irritation for individuals with latex sensitivities or allergies, there are no other side effects.

Similarly, since cervical caps and diaphragms do not use hormones, they do not alter your period or have the ability to make you sick. Cervical caps and diaphragms both require spermicide to be more effective, there are some side effects from using spermicide as well. The most common chemical in spermicides, nonoxynol-9, can irritate your vagina.

Because of this irritation, using a cervical cap and diaphragm can increase your risk of STDs, especially HIV. While spermicide is not a hormone, use of spermicide makes some women feel it is not a natural birth control and seek different non hormonal birth control options.

Additionally, using them can increase urinary tract infections (UTIs), especially if you have an incorrect size. Talk to a doctor if your diaphragm feels uncomfortable, your vagina is sore or itchy, or if you have a burning sensation when you urinate.

It is very rare, but possible for individuals using cervical caps or diaphragms to develop toxic shock syndrome. Call a doctor right away if you are vomiting, have aching muscles or a rash, are feeling faint, or have a sudden high fever.

Hormone Free Birth Control: ParaGard, the Copper IUD

An IUD, or intrauterine device, is a type of birth control device that is inserted into your uterus and can be left in for up to 12 years. There are two main types of IUDs – copper IUDs, like ParaGard, and hormonal IUDs, like Mirena or Skyla. Copper IUDs work by changing the direction of sperm (sperm does not like copper and wants to stay away).

Hormonal IUDs have similar side effects as birth control pills or other hormonal birth control. Both types of IUDs are extremely effective and because they can be left in for so long, are a good choice for women who want a “set it and forget it” approach to birth control.

The copper IUD is a method of birth control without hormones and can be used by people with a preference for non-hormonal or have a history of medical problems because of birth control hormones. Many women prefer this method for natural birth control as it is extremely effective, hormone free, and requires no upkeep. This does not mean that the copper IUD does not come with any side effects.

All kinds of IUDs, even the copper IUD, can have negative side effects that usually go away in 3 to 6 months. These can include:

  • pain upon insertion of the IUD
  • backaches or cramps following the procedure
  • irregular periods
  • spotting between periods, and with the copper
  • worse menstrual cramps and heavier periods

Although rare, there are some even more serious complications that can happen:

  • The IUD can slip: It is possible, though very unlikely that the IUD can slip and need to be removed.
  • Risk of ectopic pregnancy: It is also possible to still get pregnant with an IUD and if the IUD stays in place, there is an increased risk of ectopic pregnancy, where the egg is fertilized in some place other than the womb.
  • Infection upon insertion: There is a small chance of infection when inserting the IUD, which can jeopardize your ability to get pregnant in the future.

Call a doctor right away if you have any of the following warning signs:

  • the length of the IUD string changes or you can feel the IUD
  • you think you may be pregnant
  • you have abdominal pain or bad cramping
  • you have pain or bleeding during sex
  • you have unexplained trouble breathing
  • fever
  • chills
  • abnormal vaginal discharge

Other Options: What Hormones are in Birth Control?

For birth control that uses hormones to prevent pregnancy, most have a combination of progesterone and estrogen. Estrogen is typically the reason for the side effects that accompany birth control pills, the birth control vaginal ring, and the birth control patch.

These side effects include breast tenderness, headaches, nausea, and sometimes blood clots that in very rare cases be fatal. Some methods or brands have more estrogen than others. Because of these side effects, some women seek options called low dose birth control.

Low dose birth control usually refers to the amount of estrogen micrograms in birth control pills. It is sometimes also referred to as low estrogen birth control. In the 1960’s, birth control pills had around 150 micrograms of estrogen. Today, the highest doses have 50 micrograms and low dose is generally considered 35 micrograms or less.

Some common brands that are low-dose, include Yasmin, Levora, and Estrostep. Some doctors may refer to “ultra-low-dose” pills with 20 micrograms or less, such as Yaz, Micrette, and Alesse. These pills can come with side effect trade offs. Instead of headaches and nausea, some women get bleeding between periods or increased pelvic pain.

Women who are looking for period control, period symptom control, or birth control targeted at other factors (such as acne) are going to have more success with combination pills that include higher doses of estrogen.

Progesterone only birth control, sometimes called a minipill, is a form of birth control pills that includes no estrogen and therefore is not a combination pill. If you are concerned about combination pill sensitivity, are breastfeeding, or have a history of blood clots, this form can be especially effective.

This pill can come with less side effects as combination pills or similar side effects, varying from person to person. It is best to talk to your doctor about which method would be best for you.

Progestin Only Birth Control: Birth Control Pills, Birth Control Shot, Birth Control Implant, and the Hormonal IUD

Of the birth control methods that use hormones, there are a number of methods that use progestin-only and contain no estrogen. These include:

  • Birth Control Shot, often known as the depo shot (based on the brand name Depo-Provera). The birth control shot is an injection you get from a nurse or doctor once every 3 months. This type of birth control is convenient for people who don’t want to take a pill every day, but it does require regular visits to the doctor because the shot only works when administered on time. Like other forms of birth control, the birth control shot contains levels of hormones to help prevent ovulation or the fertilization of an egg.
  • Birth Control Implant is a small, matchstick sized rod that gets placed right underneath the skin to help prevent pregnancy. According to some medical professionals, the birth control implant is one of the most effective types of birth control (it boasts a 99% effectiveness rate, according to Planned Parenthood). Another nice thing about the birth control implant is that it can be inserted and left for up to 4 years with no maintenance. Common names for this type of birth control include Nexplanon and Implanon.
  • Hormonal IUD works in the same way as the birth control implants mentioned above, by releasing hormones to prevent ovulation and to thicken cervical mucus in order to prevent sperm from fertilizing. Other than being effective and very convenient, hormonal IUDs also have the benefit of making periods lighter, reduce cramps, or stop periods altogether. Additionally, they can help treat severe cramps, anemia, and really heavy periods.

Each of these methods come with similar side effects. Positive side effects can include:

  • Making your period lighter or even stopping your period
  • Helping protect against ectopic pregnancy and ovarian and endometrial cancers

There are a number of negative side effects that often drive women to seek natural birth control:

  • It is common for women to have their periods change, including spotting between periods and bleeding more regularly, especially during the first year.
  • Other commonly reported side effects include: sore breasts, nausea, headaches, weight gain, unusual hair loss or gain, pain where birth control method was applied, and depression. While these side effects are common, they usually go away in 2 to 3 months.

While exceptionally rare, there are very serious risks that can accompany each of these methods. Learn more about specific side effects for each method and talk to a doctor about which one is right for you.

Choosing the Best Birth Control for You

Finally, birth control pills, the birth control vaginal ring, and the birth control patch are all forms of birth control that include a combination of the hormones progestin and estrogen. While estrogen is linked to many side effects, that does not necessarily mean it is bad for you or that it is not right for you. Each method comes with trade offs and millions of women choose to take these combination methods every year. Learn more about each type to better understand which method might be right for you.

How PlushCare Works

Getting a prescription online for birth control with a telehealthcare site like Plushcare.com is easy and convenient:

Book an appointment – Most appointments are available every 15 minutes.

Chat with a doctor – Speak with the doctor of your choice for 15 minutes. You can request your usual prescription or ask your doctor questions about choosing another brand of birth control.

Pick up your prescription – After the consultation with your doctor, you can pick up your prescription for birth control at a pharmacy near you.

Read more from our Birth Control series:

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